Having a tongue thrust is kind of like having a puppy. You leave them alone for long, and oh, what a mess they can create! I was recently asked an interesting question, “I already had orthodontic treatment, so shouldn’t that have fixed my tongue thrust? Why do I still need myofunctional therapy?” Great question! Orthodontics doesn’t “fix” tongue thrusts any more than an auto body shop can “fix” a reckless driver. Orthodontists can straighten out the crooked teeth and improper bite that happen as a result of a tongue thrust, but it doesn’t fix the tongue thrust itself.

What causes tongue thrust?

Tongue thrust begins when the tongue improperly rests on the floor of the mouth instead of up against the roof of the mouth, as it should. This low resting tongue position can happen for a variety of reasons, but these are two of the most common causes:

• Tongue Tie: With a tongue tie, the tongue can’t rest against the palate because it is physically tethered to the floor of the mouth. In this case, a frenectomy (a minor surgical procedure done to release the restricted string of tissue under the tongue) is often indicated. Tongue ties are a lot more common than people think, and that is why it is important that any evaluation for tongue tie include both a visual inspection and a functional evaluation of your tongue movement because proper function is so critically important!
• Toxic Oral Habits (thumb/object sucking, pacifier use, nail biting): Toxic oral habits are like siblings sharing a bunk bed, with the offending object always hogging the top bunk, while the tongue is relegated to the bottom one. When these toxic oral habits are repeated over a period of years, the tongue, now chronically forced to the floor of the mouth, learns new patterns of dysfunction. What once seemed like an innocent and long-forgotten childhood habit frequently leads to consequences that linger long into adulthood.

Why does it matter where my tongue rests?

We swallow an incredible 1200-2000 times per day, ideally with the entire tongue, front to back, moving up against the palate when we properly swallow and resting against the palate between swallows. On the other hand, a tongue resting in the floor of the mouth places light, constant pressure against the back of the teeth during rest and pushes forward and against the teeth with every swallow. These combined forces cause the teeth to move, often resulting in open bites, overjet and dental crowding. Essentially, the tongue and surrounding structures learn to compensate in order to swallow, but at a very high price! Orthodontic treatment will take longer, as a virtual pushing match plays out between the braces on the outside of the teeth and the tongue on the inside of the teeth, with the tongue eventually winning the battle once the braces are removed resulting in orthodontic relapse. To add insult to injury, tongue thrust can also lead to speech problems and is always seen creeping through the dark halls of destruction with its lesser known partner in crime, mouth breathing, a habit that affects not only oral structures, but the health of the entire body.

How can myofunctional therapy help?

Just releasing the tongue tie or stopping the toxic oral habit is not enough because the tongue, through muscle memory, continues to operate in the only way it knows how: with dysfunction. An old adage comes to mind here, “If you always do what you have always done, you will always be where you have always been.” Old habits die hard, so something must be done to interrupt this habitual cycle of dysfunction. Myofunctional therapy is a proven, natural treatment using exercises that help you to make new neuromuscular connections and build muscle strength and coordination, essentially retraining the muscles of the tongue, face, lips and throat so that they can begin to function properly again. Myofunctional therapy is an important part of the team approach I employ with your orthodontist to help prevent orthodontic relapse and achieve that beautiful smile you desire and results that will last for a lifetime!